New School Registration Form

Oregon Model United Nations

Name of School ^*	A value is required.
School Address ^*	A value is required.
School City ^*	A value is required.
School State (two letters only) ^*	A value is required.
School ZIP Code ^* (Format: 98765 - numbers ONLY, no dashes)	A value is required.
School Phone ^* (Format: 5039876543 - numbers ONLY, no dashes)	A value is required.
School Fax ^* (Format: 5039876543 - numbers ONLY, no dashes)	A value is required.
Advisor's Name ^*	A value is required.
Advisor's Phone ^* (Format: 5039876543 - numbers ONLY, no dashes)	A value is required.
Advisor's School E-mail Address ^*	A value is required.
Advisor's Home Address ^* Personal data will ONLY be used in emergency!	A value is required.
Advisor's City ^*	A value is required.
Advisor's State ^* (two letters only)	A value is required.
Advisor's ZIP Code ^* (Format: 98765 - numbers ONLY, no dashes)	A value is required.
Advisor's Home Phone ^* (Format: 5039876543 - numbers ONLY, no dashes)	A value is required.
Advisor's Home E-mail Address ^*	A value is required.
What kind of organization will your program be? ^*
Class-based Club-based

^* Required

If there are difficulties in submitting this form electronically, please print it out and mail it or fax it to Jim Savard:

Jim Savard
721 NW Sandy
Grants Pass, OR 97526

Fax: 1 - 541 - 476 - 0694

MUN Spring Conference
April 7, 8 and 9, 2011
University of Oregon
Eugene, Oregon

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